Device that can be mounted on a surgical sewing machine to form an end-to-end anastomosis between two hollow organs, suturing machine and process thereof

Abstract

A process and a device are provided for forming an end-to-end anastomosis on two hollow organs, which can be attached to a surgical suturing machine with at least one driven needle bar with a thread-carrying needle, a shuttle cooperating with this needle, a needle plate and a holding-down device accommodated by a push rod. A carrier ( 9 ) is provided designed as a hollow cylinder and has a longitudinal slot ( 13 ) for the edge areas of the two hollow organs. The carrier can be connected by a bracket to the housing shaft of the suturing machine in such a way that its longitudinal axis runs transversely to the path of movement of the needle, and its contact area for the two hollow organs is directed essentially parallel to the plane of the contact surface of the needle plate of the suturing machine.

1. A device for forming an end-to-end anastomisis on two hollow organs, which can be attached to a suturing machine with at least one motor driven needle bar with a thread-carrying needle, a shuttle cooperating with same, a needle plate, and a holding-down device for the material to be sutured accommodated by a push rod, the device comprising:
 a carrier comprising a hollow cylinder having a longitudinal axis that is configured to extend at an acute angle to the contact surface of the needle plate of the suturing machine and having a longitudinal slot for edge areas of the two hollow organs to be connected to one another; 
 a bracket for connecting said carrier to the a housing shaft of the suturing machine in such a way that a longitudinal axis of said carrier runs transversely to the path of movement of the needle of the suturing machine, and a contact area for the two hollow organs is directed essentially parallel to the plane of the contact surface of the needle plate of the suturing machine; 
 a sleeve, which is arranged coaxially to said carrier and can be rotated in relation to said carrier, said sleeve having a jacket surfact used as a contact surface for the end areas of the two hollow organs, and said sleeve having a sleeve longitudinal slot extending over at least a part of a length thereof; 
 a clamping ring wherein said sleeve has faces and can be closed on one of said faces by means of said clamping ring, said clamping ring having a longitudinal slot corresponding to said sleeve longitudinal slot; and 
 a sleeve drive, said sleeve being rotatable in relation to said carrier by means of said sleeve drive, and movement of said sleeve drive of said sleeve is diverted by the drive of the suturing machine in such a way that said sleeve makes an intermittent rotary movement in a phased manner depending on the movement of the needle bar or a push rod for the formation of a seam. 
 
     
     
       2. A device attachable to a surgical suturing machine in accordance with  claim 1 , further comprising:
 a deformable transmission means; and 
 a driving pawl mounted at said carrier, wherin at an end facing away from said clamping ring, said sleeve has teeth with which said driving pawl cooperates, said driving pawl being connected to the drive of the needle bar or the push rod in a driven manner by means of said deformable transmission means. 
 
     
     
       3. A device attachable to a surgical suturing machine in accordance with  claim 2 , wherein said driving pawl is arranged off-center to said sleeve and meshes in a nonpositive manner with an inside of said teeth. 
     
     
       4. A device attachable to a surgical suturing machine in accordance with  claim 2 , further comprising a lever accommodating said driving pawl, said lever being pivotably mounted at said carrier wherein said deformable transmission means is a Bowden cable with an end to be connected to the drive of the needle bar or of the push rod, and with another end acting upon said lever accommodating said driving pawl, which is pivotably mounted at said carrier. 
     
     
       5. A device attachable to a surgical suturing machine in accordance with  claim 4 , further comprising a spring wherein said driving pawl is held in a position of not meshing with said teeth of said sleeve by said spring. 
     
     
       6. A device attachable to a surgical suturing machine in accordance with  claim 4 , further comprising a plurality of deflections wherin said Bowden cable is routed via said plurality of deflections, one of said a plurality of deflections being arranged at said carrier and another of said a plurality of deflections being arranged at a first arm of a carrying piece of said bracket or at the housing shaft. 
     
     
       7. A device attachable to a surgical suturing machine in accordance with  claim 1 , further comprising:
 a first hinge connection; and 
 a second hinge connection, wherein said bracket comprises an angular carrying piece with a first arm connected by said first hinge connection to a spacer fastened at the housing of the surgical suturing machine, and with a second arm connected to said carrier by means of said second hinge connection, said bracket moving from a position securing an operating position of said carrier into a position in which said carrier is directed essentially parallel to the longitudinal axis of the suturing machine. 
 
     
     
       8. A device attachable to a surgical suturing machine in accordance with  claim 7 , wherein said first hinge connection and said second hinge connection are lockable. 
     
     
       9. A device attachable to a surgical suturing machine in accordance with  claim 8 , wherein said first hinge connection is detachably connected to the spacer of the housing shaft of the surgical suturing machine. 
     
     
       10. A surgical suturing machine in combination with a device for forming an end-to-end anastomosis, the combination comprising:
 the surgical suturing machine comprising:
 a motor driven needle bar with a thread-carrying needle and a suturing machine drive; 
 a shuttle cooperating with said needle bar; 
 a needle plate; and 
 a holding-down device for the material to be sutured accommodated by 
 
 a push rod; and 
 the device comprising:
 a carrier comprising a hollow cylinder having a longitudinal axis that extends at an acute angle to the contact surface of the needle plate of the suturing machine and having a longitudinal slot for edge areas of the two hollow organs to be connected to one another; 
 a bracket for connecting said carrier to the housing shaft of the suturing machine in such a way that a longitudinal axis of said carrier runs transversely to the path of movement of the needle of the suturing machine, and a contact area for the two hollow organs is directed essentially parallel to the plane of the contact surface of the needle plate of the suturing machine; 
 a sleeve, which is arranged coaxially to said carrier and can be rotated in relation to said carrier, said sleeve having a jacket surface used as a contact surface for the end areas of the two hollow organs, and said sleeve having a sleeve longitudinal slot extending over at least a part of a length thereof; 
 a clamping ring wherein said sleeve has faces and can be closed on one of said faces by means of said claiming ring, said clamping ring having a longitudinal slot corresponding to said sleeve longitudinal slot; and 
 a sleeve drive, said sleeve being rotatable in relation to said carrier by means of said sleeve drive, and movement of said sleeve drive is diverted by said suturing machine drive in such a way that said sleeve makes an intermittent rotary movement in a phased manner depending on the movement of the needle bar or a push rod for the formation of a seam. 
 
 
     
     
       11. A combination in accordance with  claim 10 , further comprising:
 a deformable transmission means; and 
 a driving pawl mounted at said carrier, wherin at an end facing away from said clamping ring, said sleeve has teeth with which said driving pawl cooperates, said driving pawl being connected to the drive of the needle bar or the push rod in a driven manner by means of said deformable transmission means. 
 
     
     
       12. A combination in accordance with  claim 11 , wherein said driving pawl is arranged off-center to said sleeve and meshes in a nonpositive manner with an inside of said teeth. 
     
     
       13. A combination in accordance with  claim 11 , further comprising a lever accommodating said driving pawl, said lever being pivotably mounted at said carrier wherein said deformable transmission means is a Bowden cable with an end to be connected to the drive of the needle bar or of the push rod, and with another end acting upon said lever accommodating said driving pawl, which is pivotably mounted at said carrier. 
     
     
       14. A combination in accordance with  claim 13 , further comprising a spring wherein said driving pawl is held in a position of not meshing with said teeth of said sleeve by said spring. 
     
     
       15. A combination in accordance with  claim 13 , further comprising a plurality of deflections wherein said Bowden cable is routed via said plurality of deflections, one of said a plurality of deflections being arranged at said carrier and another of said a plurality of deflections being arranged at a first arm of a carrying piece of said bracket or at the housing shaft. 
     
     
       16. A combination in accordance with  claim 10 , further comprising:
 a first hinge connection; and 
 a second hinge connection, wherein said bracket comprises an angular carrying piece with a first arm connected by said first hinge connection to a spacer fastened at the housing of the surgical suturing machine, and with a second arm connected to said carrier by means of said second hinge connection, said bracket moving from a position securing an operating position of said carrier into a position in which said carrier is directed essentially parallel to the longitudinal axis of the suturing machine. 
 
     
     
       17. A combination in accordance with  claim 16 , wherein said first hinge connection and said second hinge connection ar lockable. 
     
     
       18. A combination in accordance with  claim 17 , wherein said first hinge connection is detachably connected to the spacer or the housing shaft of the surgical suturing machine. 
     
     
       19. A combination in accordance with  claim 10 , wherein above the needle plate an intermediate plate running essentially parallel to same is provided with a contact surface for the above-lying hollow organ during the suturing procedure.